Adventures With Jack and Karen: Checking Out the Medical Care

Firstly, Portugal provides health care for all people (free for children and over 65) through the Centro de Saude, but The Portugal News states that about 1 million people don't have a family doctor assigned to them. As a result this can mean very long wait times for appointments and long cues, sometimes up to 4 hours even with an appointment. The physician I saw said he had worked for the public health system and his "take-home after taxes" salary was about $1,300/month - and that was after 13 years as a doctor! Needless to say, doctors and nurses are leaving the public health system for either the private sector or emigrating to other EU countries.

As residents, we qualify for the state health service at the Centro de Saude (Health Center) however since we have never paid into the national system and we can afford to purchase insurance we decided for this option. The price of our private health insurance is about $106 per month for both of us. This includes both hospital inpatient, primary care, specialists and out-patient services.

I was unsuccessful in trying to use the medical insurance website as it is only in Portuguese and requires transtlating each page or trying to reach an English speaker on the helpline (ring-ring-ring....)! I reached out to our facebook "Ex-Pat" group and discovered a better source to find a physician. The fairly new (2009) Hospital Particular do Algarve/Gambelas in Faro is our closest hospital and accepts our health insurance (not all do). Their website is much better, in English and allowed me to make an appointment quickly. I just selected the specialty I needed (orthopedics) and I could see a list of doctors. I filled in a form and received an email back in two days with an appointment scheduled for two weeks. I have repeated this process for my annual oncology consultation and mammogram which went just as smoothly.

So the day arrives and getting to the hospital without a car requires a 10 minute train ride from Olhão to Faro (75¢) and then either a taxi (about 15 minutes and cost about $12.00) or a 30 minute bus ride (cost $2.40). We took the taxi the first time then after that we figured out the bus route. I had to return the next day and did the whole trip-train/bus by myself. Everything fell into place and I even had a few minutes before the return train to shop and grab a snack. The whole process takes a bit longer than if we had a car, but hey! we're retired.

Just some observations on the hospital & care: Everyone is greeted at the entrance, takes a number and waits to check in at a central window where registration is completed. Then we went down a hallway to the outpatient consultation area and sat in a row of chairs along the wall. After a few minutes the doctor came out to call me into the room where I sat at his desk and showed him the reports from the physicians in Idaho & Oregon. No nurse, no BP or temp, no "history" taken. The doctor typed into the computor a referral for two x-rays and directed me downstairs to imaging. Again, check-in at the counter and wait 15-20 minutes. The x-ray tech had a small, but efficent room and took two x-rays. Back upstairs to the doctor, wait in the hallway for another 10 minutes and then called in. After showing me the x-rays on the computer, he typed in a referral/prescription for physical therapy and gave me a name & the general location in Olhão (because I didn't want to come back to the hospital 3 times a week!). Back to the registration desk, take a number to wait my turn and then pay my co-pay of $17.00 plus $5.25 for the x-rays. All in all, it took about 1-1/2 hours. The doctor seems absolutely "competent" and the same as any doctor I have visited in the U.S. The only difference was the cost-effective measures of not requiring superfluous exams, questions, or irrelevant detailed medical history .

Back in Olhão I searched on my Portuguese insurance website to find a physical therapist who accepted Medís insurance. There were two and reading the patient reviews directed me to Clìnica de São Miguel.

I called and spoke to the receptionist, in English, and made an appointment for two days later. An easy 10 minute walk to the clinic and absolutely no wait! The physical therapist, Adriano, did not speak any English so we did a lot of motioning and pointing and a little Google translation.